Editor's Corner

Pretty much everyone seems to agree that boosting EMR adoption among medical practices would be a good thing. The question is, who will drive the train? My feeling is that while most of the major stakeholders have something to gain, only the health insurance business is in a position to speed up the adoption process dramatically.

As I've previously noted, even young, wired doctors don't seem very motivated to invest in EMRs, so they're probably not going to take the lead. Though they may have been exposed to the idea, most consumers aren't really familiar with EMRs, so they're not going to push their family doctors across the finish line.

What about a community groundswell? After all, the associations and community groups behind regional health information networks are doing an admirable job. Still, getting the dollars together to implement large projects is quite a trick, so their participation is likely to create incremental rather than dramatic changes. And most community hospitals, meanwhile, have their hands full managing internal IT issues. While EMRs are on the radar, implementation isn't going to be at the top of most hospital IT execs' to-do list.

Even government is unlikely to push such a expensive and paradigm-shifting change through singlehandedly. Sure, they're trying. As readers of FierceHealthIT know, both the federal government and state leaders are encouraging physicians to adopt, at minimum some form of e-health technology, with a combination of carrot (funding and support) and stick (possible regulation). But to my knowledge, none are investing the amount of capital it would take to truly grease the skids as of yet.

So by my calculations, that leaves only the health plans--and there, I think we've found a winner. For one thing, they're the entities who, let's be honest, have the most money to spend on EMR initiatives (other than government, which takes way too long to appropriate it). They already have strong relationships with physicians, and as processors of claims data, know more about medical practice patterns than any other outsider.

Most importantly, health plans stand to gain a great deal--financially and strategically--if EMR technology can a) improve quality measurement, b) reduce medical errors and c) further strengthen their connections with smart physicians. With smart IT use already built into the current generation of pay-for-performance programs--and several already funding e-health to some degree--it seems they already know this, but they're not over-emphasizing IT issues yet. I think they will get more aggressive on this front soon, however.

In short, if you want to know where EMR adoption is going, ask your friendly local major health insurer about their plans. And when they tell you, listen closely. -Anne